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NPI Code Detail

MEDICARE: SAM FRANCIS LBA

MEDICARE: SAM FRANCIS LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst7401000817MI

General Provider Information

NPI Number : 1811522782
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAM FRANCIS LBA
Provider Business Mailing Address
First Line : 8285 S SAGINAW ST
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2468
Country : US
Telephone Number : 844-854-6878
Fax Number :
Provider Business Practice Location Address
First Line : 8283 OFFICE PARK DR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2032
Country : US
Telephone Number : 810-321-3001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2020
Last Update Date : 11/02/2022

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